In this application, we propose to establish a clinical center to participate as one of 15 centers in the "Mortality and Morbidity in Hemodialysis Patients (MMHD): Full Scale Trial". This trial has been developed to help identify possible treatment interventions leading to a reduced rate of morbidity and mortality of patients on hemodialysis. Patients will be randomized in a two-by-two factorial clinical trial to determine whether increased delivered hemodialysis and high flux dialysis will reduce morbidity and mortality rates for this patient population.